Antibiotics Introduction

Antibiotics, also known as antibacterials, are types of medications that destroy or slow down
the growth of bacteria. The Greek word anti means "against", and the Greek word bios means
"life" (bacteria are life forms).
Antibiotics are among the most frequently prescribed medications in modern medicine.
Antibiotics cure disease by killing or injuring bacteria. The first antibiotic was penicillin, discovered
accidentally from a mold culture. Today, over 100 different antibiotics are available to cure minor, as well
as lifethreatening infections.
Although antibiotics are useful in a wide variety of infections, it is important to reali!e that
antibiotics only treat bacterial infections. Antibiotics are useless against viral infections "for e#ample, the
common cold$ and fungal infections "such as ringworm$. %our doctor can best determine if an antibiotic is
right for your condition.
The first antibiotic was penicillin. &uch penicillinrelated antibiotics as ampicillin, amo#icillin
and ben!yl penicilllin are widely used today to treat a variety of infections these antibiotics have been
around for a long time.
Types of Antibiotics
Although there are well over 100 antibiotics, the majority come from only a few types of drugs. These
are the main classes of antibiotics.
'enicillins such as penicillin and amo#icillin
(ephalosporins such as cephale#in")efle#$
*acrolides such as erythromycin "+*ycin$, clarithromycin ",ia#in$, and a!ithromycin "-ithroma#$.
.luoroquinolones such as ciproflo#acin "(ipro$, levoflo#acin "/evaquin$, and
oflo#acin ".lo#in$.
&ulfonamides such as cotrimo#a!ole ",actrim$ and trimethoprim "'roloprim$
Tetracyclines such as tetracycline"&umycin, 'anmycin$ and do#ycycline"0ibramycin$
Aminoglycosides such as gentamicin "1aramycin$ and tobramycin "Tobre#$
*ost antibiotics have 2 names, the trade or brand name, created by the drug company that manufactures
the drug, and a generic name, based on the antibiotic3s chemical structure or chemical class. Trade names
such as )efle# and -ithroma# are capitali!ed. 1enerics such as cephale#in and a!ithromycin are not
capitali!ed.
How do antibiotics work?
&ome antibiotics work by killing bacteria or the parasite. This is often done by interfering with the
structure of the cell wall of the bacterium or parasite. &ome work by stopping bacteria or the parasite from
multiplying.
ew Antibiotics
!lass Generic"#rand
/ipopeptides 4aptomycin "(ubicin$, 2005
.luoroquinolone 1emiflo#acin ".active$, 2005
/ipoglycopeptides Telavancin "0ibativ$, 2006
(ephalosporin
"7th generation$
(eftaroline "Teflaro$, 2010
*acrocyclics .ida#omicin "4ificid$, 2011
$%&actam Antibiotics
,etalactam antibiotics include penicillins, cephalosporins, monobactams, and carbapenems.
'enicillins
Generic #rand ame
Amo#icillin Amo#il, 'olymo#, Trimo#, 8ymo#
Ampicillin 9mnipen, 'olycillin, 'olycillin:,
'rincipen, Totacillin
ntibiotics work in two different ways either by killing the bacteria or blocking its function. They only
attack the bacterial population present in the body and causing the disease, they do not affect the cell of
the body. ;t is an unfortunate fact that though antibiotics are being used constantly but now bacteria have
developed resistance against these drugs. ;t is a very natural process that new antibiotics with more
effectiveness are being developed and bacterial genome is revolutioni!ing against these newly
synthesi!ed antibiotics.
An antibiotic has also the ability to convert glucose in the body into energy. ;t produces a protective wall
against bacteria and does not allow them to enter the cell. ;t also protects the body from further infection
and prevents the bacteria to multiply in number.
Though antibiotics are useful in curing the human body against bacterial infections but they also have
some side effects. A patient can suffer from slight headache to e#treme allergic reaction. Another side
effect is diarrhea in which the balance of the intestinal flora gets affected and disrupts the function of the
useful bacteria present in the intestine. ;n some cases, antibiotics can react with other drugs administered
along with them and cause other infections.
;n the past before the discovery of antibiotics, the diseases like cholera and diarrhea would be fatal as
these diseases dehydrate the body and makes the individual weak. Antibiotics have the credit of saving so
many lives by killing the microbes causing certain diseases. ;n the disease of tuberculosis, antibiotics
play an important role in eradicating the bacteria. To protect the patient from having side effects, doctors
prescribe such antibiotics which suit person<s body.
A summary of the main effector defense mechanisms against e#tracellular bacteria. ,acteria that avoid
destruction by the classical or alternative complement pathways may be opsoni!ed by acute phase
reactants or specific antibodies and engulfed by phagocytes e#pressing receptors for the .c region of
these antibodies.
he first generation cephalosporins include= Their spectrums of activity are quite similar. They possess
generally e#cellent coverage against most grampositive pathogens and variable to poor coverage against
most gram negative pathogens. The first generation includes=
cephalothin
cefa!olin
cephapirin
cephradine
cephale#in
cefadro#il
The second generation cephalosporins. ;n addition to the gram positive spectrum of the first
generation cephalosporins, these agents have e#panded gram negative spectrum. (efo#itin and
cefotetan also have good activity against ,acteroides fragilis. +nough variation e#ists between
the second generation cephalosporins in regard to their spectrums of activity against most species
of gram negative bacteria, that susceptibility testing is generally required to determine sensitivity.
The second generation includes=
o cefaclor
o cefamandole
o cefonicid
o ceforanide
o cefuro#ime
The third generation cephalosporins have much e#panded gram negative activity. >owever, some
members of this group have decreased activity against grampositive organisms. They have the advantage
of convenient administration, but they are e#pensive.
()erusing antibiotics There is concern worldwide that antibiotics are being overused. Antibiotic
overuse is one of the factors that contributes towards the growing number of bacterial infections which
are becoming resistant to antibacterial medications.
Antibacterial action generally falls within one of four mechanisms, three of which involve the inhibition
or regulation of en!ymes involved in cell wall biosynthesis, nucleic acid metabolism and repair, or protein
synthesis, respectively. The fourth mechanism involves the disruption of membrane structure. *any of
these cellular functions targeted by antibiotics are most active in multiplying cells. &ince there is often
overlap in these functions between prokaryotic bacterial cells and eukaryotic mammalian cells, it is not
surprising that some antibiotics have also been found to be useful as anticancer agents.
Antibiotic Grouping #y *echanism
(ell 8all &ynthesis 'enicillins
(ephalosporins
0ancomycin
,etalactamase ;nhibitors
(arbapenems
A!treonam
'olymycin
,acitracin
'rotein &ynthesis ;nhibitors ;nhibit 50s &ubunit
Aminoglycosides "gentamicin$
Tetracyclines
;nhibit 70s &ubunit
*acrolides
(hloramphenicol
(lindamycin
/ine!olid
&treptogramins
4:A &ynthesis ;nhibitors .luoroquinolones
*etronida!ole
?:A synthesis ;nhibitors ?ifampin
*ycolic Acid synthesis inhibitors ;sonia!id
.olic Acid synthesis inhibitors &ulfonamides
Trimethoprim
Antibiotic !lassification + Indications

Inhibits !ell ,all -ynthesis
'enicillins
"bactericidal= blocks cross linking via competitive inhibition of the transpeptidase en!yme$
Class/Mechanism Drugs Indications (**Drug
of Choice)
Toxicity
'enicillin 'enicillin 1
Aqueous
penicillin 1
'rocaine
penicillin 1
,en!athine
penicillin 1
'enicillin 0
Strep. pyogenes
(rp.!)@@
Step. agalactiae
(rp.")**
C.
perfringens("acilli)**
>ypersensitivity reaction
>emolytic anemia
Aminopenicillins Ampicillin
Amo#icillin
Above A
B 1ramnegative=
#. faecalis@@
#. Coli@@
Above
,ased on the prevalence of bacteria in ear and throat infections, and considering that pneumococcal vaccine is now preventing
many bacterial infections, the researchers estimated that 2C.DE of F& children with A?T; have bacterial illness.
Medicines and treatments for a throat infection
A sore throat will often get better by itself, as the bodys immune system can usually take care of the
infection without any treatment. Antibiotics arent helpful for most people with a throat infection.
ANTIGEN
An antigen is any substance that causes your immune system to produce antibodies against it. An antigen
may be a foreign substance from the environment, such as chemicals, bacteria, viruses, or pollen. An
antigen may also be formed inside the body, as with bacterial toxins or tissue cells.
An epitope, also known as antigenic determinant, is the part of an antigen that is recognized by
the immune system, specifically by antibodies, B cells, or T cells. or example, the epitope is the
specific piece of the antigen that an antibody binds to. The part of an antibody that binds to the
epitope is called a paratope. Although epitopes are usually non!self proteins, se"uences derived
from the host that can be recognized #as in the case of autoimmune diseases$ are also epitopes.
The epitopes of protein antigens are divided into two categories, conformational epitopes and linear
epitopes, based on their structure and interaction with the paratope.
A conformational epitope is composed of discontinuous sections of the antigen%s amino
acid se"uence. These epitopes interact with the paratope based on the &!' surface features and
shape or tertiary structure of the antigen. The proportion of epitopes that are conformational is
unknown.
By contrast, linear epitopes interact with the paratope based on their primary structure. A linear
epitope is formed by a continuous se"uence of amino acids from the antigen.
T cell epitopes
T cell epitopes are presented on the surface of an antigen!presenting cell, where they are bound
to ()* molecules.
The paratope is the part of an antibody which recognizes an antigen, the antigen!binding site of an
antibody. +t is a small region #of ,-.// amino acids$ of the antibody%s v region and contains parts of
the antibody%s heavy and light chains.
antigenic determinant a site on the surface of an antigen molecule to which a single antibody molecule
binds0 generally an antigen has several or many different antigenic determinants and reacts with many
different antibodies.
antigens
Any molecule that can be specifically identified by the adaptive immune system. An
antigen is a substance that activates lymphocytes by interacting with the TCR or the
BCR.
Immune tolerance or immunological tolerance describes a state of unresponsiveness of the
immune system to substances or tissue that have the capacity to elicit an immune response.
+t contrasts with conventional immune!mediated elimination of foreign antigens. Tolerance is
classified into central tolerance or peripheral tolerance depending on where the state is originally
induced1in the thymus and bone marrow #central$ or in other tissues and lymph nodes #peripheral$.
The mechanisms by which these forms of tolerance are established are distinct, but the resulting
effect is similar.
+mmune tolerance is important for normal physiology.